Risk factors and management of intra-abdominal infection after extended radical gastrectomy.
BACKGROUND
This study elucidated risk factors and management for intra-abdominal infection after extended radical gastrectomy.


METHODS
From 1988 to 2004, 2,076 patients with gastric cancer underwent extended radical gastrectomy at Taipei Veterans General Hospital. Risk factors for intra-abdominal infection were determined by analyzing clinicopathological factors, operative procedure, combined organ resection, operative time, blood loss, and associated disease(s). Management modalities were summarized.


RESULTS
The overall complication rate was 18.7%. Eighty (3.9%) patients were found to have intra-abdominal infections. Age, prolonged operation time, and combined organ resection were the precipitating factors. These patients were categorized into 3 groups: intra-abdominal abscess with adequate drainage, intra-abdominal abscess without anastomotic leakage, and intra-abdominal abscess because of leakage. Adequate drainage was the primary treatment. Mortality rate was 22.5% (18), and the most common cause of mortality was intra-abdominal abscess caused by leakage.


CONCLUSIONS
Although expert surgical skills can minimize the incidence of intra-abdominal infection, management also requires experience and training.
Lo
Chih-Hsien
CH
Division of General Surgery, Taipei Veterans General Hospital and National Yang Ming University, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan.
Chen
Jen-Hao
JH
Wu
Chew-Wun
CW
Lo
Su-Shun
SS
Hsieh
Mao-Chih
MC
Lui
Wing-Yiu
WY
D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000628:therapy